Evidence-Based Diagnostic Criteria Published for TMDs

Posted on March 31, 2014

The first evidence-based diagnostic criteria have been developed to help better diagnose temporomandibular disorders (TMD), which affect an estimated 10% to 15% of Americans. The diagnostic criteria were developed by researchers in North America, Europe, and Australia, and supported in part by the National Institutes of Health. The criteria comprise an improved screening tool to help researchers and health professionals, including dentists, more readily differentiate common forms of TMD and reach accurate diagnoses grounded in supportive scientific evidence.

“We’ve had diagnostic criteria for years,” said Eric Schiffman, DDS, a co-lead author on the article, who studies TMD at the University of Minnesota School of Dentistry, Minneapolis. “What is unique here is instead of a panel of experts empirically deciding best practices, we relied on science as a methodology to test our best assumptions and see if we were actually correct.”

Called DC/TMD, the latest criteria were published in the winter issue of the Journal of Oral and Facial Pain and Headache. The DC/TMD begins with a patient questionnaire to detect pain-related TMD. If TMD is detected, the protocol moves on to new diagnostic criteria to differentiate among common subtypes.

The psychosocial assessment screens for pain location, pain intensity, pain-related disability, psychological distress, jaw dysfunction, and presence of oral habits (eg, grinding teeth). A follow-up questionnaire is available to gauge additional anxiety measures and the possible presence of other pain-causing physical ailments. Both instruments have been scientifically validated.

“By diagnosing the person, beyond only the physical condition, a whole avenue of treatment options opens up,” said Schiffman. “Instead of prescribing mouth guards, exercises, or surgery, practitioners can consider trying bio-behavioral treatments including relaxation techniques and biofeedback to help the patient successfully manage their TMD. In short, you can better customize the treatment to fit the whole person, not just their disorder.”